Medical Claims Processor

Taking care of our customers, our communities and each other. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. the skills, education, training, credentials and experience of the candidate; As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
Target Openings
The position is responsible for investigating, evaluating, reserving, negotiating and resolving assigned Specialty Liability related Bodily Injury and Property Damage claims, or first party business property claims of moderate severity, or complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations.
Timely coverage analysis and communications with insured based on application of policy information, facts or allegations of each case. Consults with Unit Manager on use of Claim Coverage Counsel.
Investigates each claim through prompt contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Identifies resources for specific activities required to properly investigate claims such as Subrogation, Risk Control, Salvage and fire or fraud investigators and to other experts. Requests through Unit Manager and coordinate the results of their efforts and findings.
Keeps effective diary management system to ensure that all claims are handled timely. Responsible for prompt, cost effective, and proper disposition of all claims within delegated authority.
Negotiates disposition of claims with insureds and claimants or their representatives.
Maintains claim files, have an effective diary system, and document claim file activities in accordance with established procedures.
May attend depositions, and any other legal proceedings, as needed.
Updates appropriate parties as needed, providing new facts as they become available, and their impact upon the liability analysis and settlement options.
Recognizes cases based on severity protocols to be referred timely to next level claim professional or Major Case Unit.
Appropriately deals with information that is considered personal and confidential.
Fulfills specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC) instructions, and inquiries from agents and brokers.
Represents the company as a technical resource, attends legal proceedings as needed, act within established professional guidelines as well as applicable state laws.
Provides quality customer service and ensures file quality.
Shares accountability with business partners to achieve and sustain quality results.
In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be is required to comply with state and Travelers requirements. Meets all quality standards and expectations in accordance with the Knowledge Guides.
Bachelor's Degree preferred.
Demonstrated knowledge and ability in claims handling.
Advanced level knowledge and skill in claims and litigation.
Strong keyboard skills and Windows proficiency, including Excel and Word
Insurance Contract Knowledge- Intermediate
A minimum of one year liability or property claim handling experience required.
Employees and their eligible family members – including spouses, domestic partners, and children – are eligible for coverage from the first day of employment.
Retirement: When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. We believe that we can deliver the very best products and services when our workforce reflects the diverse customers and communities we serve. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.